Management of testicular torsion <360° in children: a single-center, retrospective study

J Int Med Res. 2020 Apr;48(4):300060519895861. doi: 10.1177/0300060519895861. Epub 2019 Dec 31.

Abstract

Objective: This study aimed to summarize clinical manifestations, and physical examination, laboratory examination, and ultrasound results of children with testicular torsion <360°.

Methods: We performed a retrospective study of children who were diagnosed with testicular torsion <360° between October 2007 and October 2017.

Results: There were 11 (19.2%) patients with testicular torsion of 90°, 33 (58.0%) with 180°, and 13 (22.8%) with 270°. The median age of onset was 5.7 years (range, 1-14 years) and the median duration of symptoms was 4.2 days (range, 0.5-5 days). Ultrasound showed low blood flow in 46 (80.8%) patients. The testis was retained in 41 (72.0%) patients and resected in 16 (28.0%). The testes appeared necrotic at 2 to 3 days after onset for patients with 270° torsion, appeared necrotic at 3 to 4 days after onset for those with 180° torsion, and were not necrotic at 4 to 5 days after onset for those with 90° torsion. The duration of symptoms in children decreased as the torsion angle increased.

Conclusion: Children with testicular torsion <360° are relatively young, while the duration of symptoms is relatively long. A high postoperative testicular survival rate is one of the clinical features in this study.

Keywords: Doppler ultrasound; Testicular torsion; atrophy; children; cremasteric reflex; necrosis.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Humans
  • Infant
  • Male
  • Necrosis
  • Retrospective Studies
  • Spermatic Cord Torsion* / diagnostic imaging
  • Spermatic Cord Torsion* / surgery
  • Testis
  • Ultrasonography, Doppler, Color